3430 COLBY AVE 2019-11-01 - Laserfiche WebLink

08/21/2019 13 : 14 #4378 P. 002/002 PERMIT APPLICATION 1112 BUILDING/MECHANICAL I PLUMBING 1 SIGN /SPRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettWa-goo I www.everettwa.goV/permits ,(ewE .J thia;+i ' lk: 1,1100004):..:,'': ' ; tc> Irk al1TE,INF`ORMA I l PROJECT SITE ADDRESS:3430 COLBY AVE PROPERTY TAX#: LEGAL for new construction: Short Platfsubdivision Lot No. (attach copy of long legal description) . '7 ,:CON 'ACT''.INFORMATION .. OWNER NAME: BRUCE NIXON DDS TENANT BUSINESS NAME(Commercial): -- )wi111\ OWNER MAILING ADDRESS: sTREET3430 COLBY AVE kW lit(iii()_ clTr EVERETT STATE WA zip 98201 OWNER PHONE:425.259.6551 OWNER EMAIL: CONTRACTOR NAME:EYIANDEER SALES & SERVICE CONTRACTOR ADDRESS: STREEr3601 EVERETT AVE c,,, EVERETT srATF WA zip 1 016363 CONTRACTOR LICENSE CREQUIRED):EYLANSS042K2 CITY OF EVERrt BUSINEsS LICENSE IRREQUIRED): 1.0.0 .... PRIMARY CONTACT: 0 OVVNER 0 CONTRACTOR 0 OTHER(Please SpecifY) CONTACT NAME: CONTACT PHoNE:425.231.2275 CORNELIUS TOO ME OTHER CONTACT iBUI L D I N G:INFORMATION Existing Use of EEuntitr g:DENTAL OFFICE Contract Price of Work:$12000 Proposed Use of Building:DENTAL OFFICE Heat Source: Deas OEiectric ❑Other BUILDING USE CISFR ❑Townhouse ❑Duplex QADU ❑Multi-Family-#Units: 2jCommercial ❑Ari ssory Structure Type of Project: ❑Now ❑Addition QRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: REPLACE 2 HEAT PUMPS ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL: PERMIT APPLICATION ,,•; ` . .,:; •' PLUMBING=PERMIT'APPLICATION "" Falure FarWs Fixture Fixture Count List of Fixtures CQura fist of Fixtures Count List of Fixtures Count List of Fixtures NC-Air Handling Units Gas Piping Backtow Preventer(Inside Bldg) Shower,Tub, or Combo Boiler _Gas_Ran e Clothes Washer Sink-Commercial(3-comp,prcp,floor) _Clothes Dryer 2 Heat Pu .. ■ Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type LI) Water Heater Interceptor-Grease Waste/Water Piping Repair __ Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind mete) ForcedlAir Systems Other: _ Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater $PRINKLBR` .SUPPRrSZION SYSTEM Sewage Ejector or Sump Pump Other }Nater Suppression System NQ.of Reads Chemical Suppression System [Na,of Heads ACKNOWLEDGEM.NT.I have reviewed this application and confirm the information contained herein is true and correct, Work done pursuant to this permit must compry with current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Dsvletions must first be authorized in writing from the Building Official before being authorized under any circumstance.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 1827 RCW and 286.200A WAC. City of Everett Official Use Only / [PRI IMITCY '1DB-o �- • :r/Authorized ••pant :Ignaturo •ate (Revised 16/10/2018) (iiL1-